title: Brugada-type patterns are easily observed in high precordial lead ECGs in collegiate athletes.
abstract: BACKGROUND
  Displacement of ECG leads can result in unwarranted findings. We assessed the frequency of Brugada-type patterns in athletes when precordial leads were purposely placed upward.
  
  
  METHODS
  Four hundred ninety-one collegiate athletes underwent two ECGs: one with standard leads, one with V1 and V2 along the 2nd intercostal space. A positive Brugada-type pattern was defined as ST elevation in V1 or V2 consistent with a Type 1, 2, or 3 pattern in the high-lead ECG. A control group was comprised of 181 outpatients.
  
  
  RESULTS
  No Type 1 patterns were seen. In 58 athletes (11.8%), a Brugada-type 2 or 3 pattern was observed. Those with Brugada-type 2 or 3 patterns were more likely male, taller, and heavier. In the control group, 18 (9.9%) had Brugada-type 2 or 3 patterns and were more likely male.
  
  
  CONCLUSIONS
  Proper lead positioning is essential to avoid unwarranted diagnosis of a Brugada-type ECG, especially in taller, heavier male athletes.
authors.affiliation: Division of Cardiology, Cardiac Electrophysiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: ehchung@med.unc.edu.
authors.forename: Eugene H
authors.initials: EH
authors.lastname: Chung
authors.affiliation: Division of Cardiology, Cardiac Electrophysiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: McNeely
authors.affiliation: Division of Cardiology, Cardiac Electrophysiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Anil K
authors.initials: AK
authors.lastname: Gehi
authors.affiliation: Division of Sports Medicine, Campus Health Services, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Brickner
authors.affiliation: Division of Sports Medicine, Campus Health Services, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Evans
authors.affiliation: Division of Sports Medicine, Campus Health Services, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Edmund
authors.initials: E
authors.lastname: Pryski
authors.affiliation: Division of Sports Medicine, Campus Health Services, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Waicus
authors.affiliation: Division of Sports Medicine, Campus Health Services, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Harry
authors.initials: H
authors.lastname: Stafford
authors.affiliation: Division of Cardiology, Cardiac Electrophysiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: J Paul
authors.initials: JP
authors.lastname: Mounsey
authors.affiliation: Division of Cardiology, Cardiac Electrophysiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Jennifer D
authors.initials: JD
authors.lastname: Schwartz
authors.affiliation: Division of Cardiology, Cardiac Electrophysiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Sihong
authors.initials: S
authors.lastname: Huang
authors.affiliation: Division of Cardiology, Cardiac Electrophysiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Irion
authors.initials: I
authors.lastname: Pursell
authors.affiliation: Division of Sports Medicine, Campus Health Services, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Mario
authors.initials: M
authors.lastname: Ciocca
mesh_terms: D000328:Adult; D016477:Artifacts; D053840:Brugada Syndrome / Q000175:diagnosis*; D004562:Electrocardiography / Q000295:instrumentation* / Q000706:statistics & numerical data*; D004566:Electrodes / Q000706:statistics & numerical data*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D009657:North Carolina; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012737:Sex Factors; D013177:Sports / Q000706:statistics & numerical data*; D014495:Universities / Q000706:statistics & numerical data
keywords: Athletes; Brugada-type ECG; ECG; Early repolarization; Electrocardiogram; Electrocardiogram (ECG); HL ECG; High (precordial) lead ECG; SUDS; Screening; UNC; University of North Carolina at Chapel Hill; sudden unexplained death syndrome